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Pre-Op Assessment: Dr. Ayesha Ehsan House Surgeon S-II
Pre-Op Assessment: Dr. Ayesha Ehsan House Surgeon S-II
ASSESSMENT
DR. AYESHA EHSAN
House Surgeon S-II
Definition
• The pre-operative period runs from the time the patient is admitted
to the hospital till the time when the surgery begins
• The pre-operative assessment is an opportunity to identify co-
morbidities that may lead to patient complications during the
anaesthetic, surgical, or post-operative period. Patients scheduled for
elective procedures will generally attend a pre-operative assessment
2-4 weeks before their date of surgery.
AIM
• To identify high-risk patients and alleviating the risk factors associated
with surgery
• Decreased post-op recovery time and length of hospital stay.
• Decreased anxiety of patient related to major surgeries
STEPS OF PRE-OP ASSESSMENT
• History
• Systemic examination
• Investigations
• Pre-op treatments and counselling
• Documentation
• Valid consent
PRINCIPLES OF HISTORY TAKING
• Listen: What is the problem? (Open questions)
• Clarify: What does the patient expect? (Closed questions)
• Narrow: Differential diagnosis (Focused questions)
• Fitness: Comorbidities (Fixed questions)
Examination
• General: positive findings even if not related to the proposed
procedure should be explored
• Surgery related: Type and site of surgery, complications which have
occurred due to underlying pathology
• Systemic: Comorbidities and their severity
• Specific: For example, suitability for positioning during surgery.
General Physical Examination
• To check fitness for anesthesia & surgery.
• GPE
• Systemic:
- CVS
- CNS
- GIT
- Respiratory system
Specific Surgical Examination
• to confirm previous findings & diagnosis
• to determine severity
• to gauge extent.